Organization
FOUNDATIONS FAMILY MEDICINE PC
Active
Organization
FOUNDATIONS FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM E COOKE MD (DIRECTOR/OFFICER)
(812) 794-8100
Entity
Organization
Contact information
Practice address
25 W MAIN ST, AUSTIN, IN 47102-1303
(812) 794-8100
(812) 794-8200
Mailing address
25 W MAIN ST, AUSTIN, IN 47102-1303
(812) 794-8100
(812) 794-8200
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
01056407A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200490500A
—
IN
01
—
DC0744
RR MEDICARE
IN
Enumeration date
08/05/2006
Last updated
07/01/2013
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